Colic Flashcards

1
Q

What is colic?

A

abdominal pain (tummy ache)

  • group of clinical signs that not only caused by the GIT
  • one of the most common causes of death
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2
Q

What are some non-GI causes of colic?

A
  • Pneumonia
  • Uterine torsion
  • Renal or bladder stones
  • laminitis
  • tying up
  • neurological diseases
  • Normal foaling, abortion and dystocia
  • ruptured bladder
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3
Q

What are some GI causes of colic?

A
  • esophageal obstruction
  • Equine gastric ulcer syndrome (EGUS)
  • intestinal obstructions
  • Duodenitis-proximal jejunitis (DPJ)
  • Parasite impaction
  • Ileus
  • ingunial hernia
  • sand impaction of large colon
  • nephroplenic entrapment
  • right dorsal displacement of the large colon
  • large colon volvulus
  • large colon impaction
  • right dorsal colitis due to NSIAD toxicity
  • Potomas Horse fever
  • salmonellosis
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4
Q

What are the clinical signs colic?

A
  • pawing
  • rolling (violent and other)
  • kicking or biting abdomen
  • repeated turning to look at flank
  • posturing to urinate
  • sweating
  • repeated lying down and getting up
  • sitting in dog-like position or lying on back
  • lack of appetite
  • putting head down to water without drinking
  • rapid respiration and/or flared nostrils
  • teeth grinding
  • fewer feces indicating lack of bowel movements
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5
Q

What are the 3 steps a vet should take when facing a possible colic case?

A
  1. gather information about history of horse
  2. gather colic specific history on the horse
  3. perform a physical exam
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6
Q

What do you need to know during the gather information about history phase of facing a possible colic case?

A
  • living conditions, pasture? stall?
  • feed
  • daily routine, changes in routine
  • medical history, colic history
  • colic surgery
  • parasite control
  • pregnant
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7
Q

What kinds of things do you need to ask in terms of colic related history?

A
  • duration of colic signs
  • last time fed
  • last time seen defecating
  • have clinical signs worsened. has pain worsened.
  • administered medications, analgesia, sedatives, have they helped?
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8
Q

What do you look for during the physical exam?

A
  • Temperature (norm= 37.8 degrees C), Respiration (norm= 10-14), and heart rate (norm= 28-40) –> increases can reflect pain
  • attitude
  • mucosal membranes -> purple = toxemia, pale and tacky= dehydration
  • distended abdomen?
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9
Q

What is the caution with a heart rate above 50?

A

pain, low blood volume, perfusion or endotoxemia

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10
Q

What is an exam/diagnostic test you can do to test for colic?

A
  • nasogastric incubation
  • Auscultation
  • rectal palpation
  • Abdominocentesis
  • ultrasound
  • blood tests
  • fecal culture/PCR
  • sand test
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11
Q

What is nasogastric incubation?

A

critical procedure to relieve pressure in the stomach and examine reflux

  • place tube through nares down esophagus into stomach
  • blockage will result in build up of fluids in stomach so tube will allow this an exit.
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12
Q

During a nasogastric incubation what must you consider regarding the fluid in the stomach?

A

amount, color, smell and pH

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13
Q

What kind of fluid indicates an obstruction in the small intestine?

A

greater than 2 L fluid and alkaline pH

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14
Q

What kind of fluid indicates duodenitis-proximal-jejunitis

A

3-6 L fluid/hr for 3-7 days, brown and fetid odour

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15
Q

what is auscultation?

A

listening with stethoscope for frequency, intensity and duration of sounds

  • should be sounds in all four quadrants
  • is there a percussion or ping?
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16
Q

What is a rectal palpation used for?

A

to determine if there is distension and in what part of the GIT

17
Q

Where can distension caused by colic be found?

A
  • spleen, left kidney, nephrosplenic space, base of mesentery, feel pulse pulse in aorta, cecum(normally flaccid), pelvic brim and inguinal rings, bladder, pelvic flexure of large colon, dorsal and ventral colon (can feel the difference based on anatomy), and small colon
18
Q

What is abdominocentesis? what does it help with?

A

collection of fluid from the peritoneal cavity

- helps identify strangulating legions (red color= necrotic gut, measure protein, look at cells under microscope

19
Q

What is the sand test?

A

put feces in bag/container with water and sand in feces will sink to bottom

20
Q

When is surgery needed in a colic case?

A
  1. pain: uncontrollable with common drugs and/or severe or progressively worse
  2. Gastric reflux: greater than 2L fluid, alkaline and/or yellow
  3. Rectal exam: abnormal
    - -> distended small intestine
    - -> distended and displaced large colon
    - -> distension unresponsive to medical treatment
    - palpable foreign body
  4. peritoneal fluid: increased protein with red blood cells or white blood cells with evidence of bacteria
21
Q

When can colic be medicated?

A
  1. no pain or easily controlled
  2. high temperature
  3. few white blood cells = serious infection
  4. normal motility when auscultate
22
Q

What are the three key steps of treatment?

A
  1. analgesia (NSAIDs, sedatives, opiates)
  2. fluid therapy (laxatives, oral fluids, IV fluids)
  3. Husbandry (fasting, preventing self ingery, etc.)
23
Q

Why is analgestia important for colic treatment?

A
  • control of pain is most important therapeutic factor for all colics
24
Q

Why are fluids important when treating colic?

A
  • corrects dehydration
  • softens intestinal contents
  • administer with IV or stomach tube
  • laxatives (mineral oil or psyllium mucilloid for sand colic)
25
Q

Why is fasting important for colic treatment?

A

re-introduce food slowly until horse has passed significant quantity of feces and/or mineral oil.

26
Q

What are the classifications of colic?

A
  • distension
  • simple obstruction or blockage
  • obstruction or blockage with partial or complete shut-off of blood supply
  • enteritis or colitis (inflammation)
27
Q

What is distension colic?

A
  • no blockage but digestive material cannot move for some reason so you get colic
  • -> painful
28
Q

What is simple obstruction or blockage colic?

A
  • material cannot move in GIT due to an obstruction but vascular flow remains intact
  • -> mild to moderate pain and slow to progress
29
Q

What is obstruction or blockage with partial or complete shut off of blood supply colic?

A

“strangulating obstruction”

  • constant and severe pain with rapid development of shock due to intestinal death and subsequent release of toxins and bacteria into the bloodstream
30
Q

What is Enteritis/Colitis colic?

A

inflammation in wall of intestine which causes stasis

31
Q

What is the prognosis of colic?

A
  • 40% recovery without therapy
  • 30% recover with moderate therapy - pain relief mineral oil
  • 20% require intense medical therapy - repeated pain control, fluids, mineral oil
  • 10% require surgery or immediate euthanasia